Patients less than 18 years of age (based on date of birth at time of data extraction for surveying)

Patients with no known fixed address

Patients who do not have a confirmed cancer diagnosis (even if they have received treatment in the facility) including in-situ, benign haematology and/or non-malignant cancers (for example myeloproliferative diseases) or those going through a diagnostic assessment process

Patients who received only inpatient services

Patients who have notified the hospital that they wish to be excluded from mailing list.

Inclusion Criteria:

Patients who have received active treatment in an ambulatory setting in the past 3 months

Patients with a confirmed diagnosis of Cancer (include those patients with diseases identified as invasive, with a 3 in the 5th position of the ICD-O-3 histology code (malignant, primary site)

Have undergone active outpatient treatment in the past 3 months

Are 18 years or older (based on date of birth at time of data extraction for surveying)

The table below highlights where sampling criteria for jurisdictions varies from the criteria outlined above.

Jurisdiction

Deviations from the standard Inclusion/Exclusion criteria

Data elements in addition to those required as per NRC Implementation Manual

Alberta

Inclusion:

Those who have been on treatment for six months.

Can identify patients who received chemotherapy and radiation treatments however surgery is not captured until approximately a year after diagnosis so the vast majority of patients will not have surgical information.

Will identify patients who received IV and/or oral chemotherapy at the tertiary centres. However at the Associate and Community cancer centres, are unable to determine the type of systemic treatment received. This will result in the inclusion of patients who received hormones and immunotherapy as well as those who received chemotherapy.

Alberta will use the ICD code for invasive cancer as used by the other provinces.

Will use age at diagnosis as prescribed on the Implementation Manual.

Nova ScotiaSurveyed Point in TimeSummer 2012

Exclusion:

Exclude in-situ bladder.

There is a flag set on each case where ‘ambiguous' terms appear on the pathology report. The histology could still be classified as /3 (invasive), but if this flag were set, the patient would not be approached.

Oral Chemotherapy patients:

There is a problem in identifying these patients. They are not specifically included or excluded. Due to limitations in the IT system, an algorithm has been developed for selecting patients that are most likely to be receiving chemotherapy based on visits to medical oncologists so oral chemotherapy patients could be part of that algorithm. Certainly oral chemotherapy is increasing and they may have different issues or not identify themselves as chemotherapy patients in the survey.

SaskatchewanSample point in time every 1 – 2 years

Exclusions:

Patients who are on injections (determined by a comprehensive drug master list from Care Services)

Patients who have restrictions in Ceres/Eureka/CMS

Patients with specific chemo/radiation events

Inclusions:

Patients who have a specific COPS institution as a scheduled event

Haematology patients (as there is no way currently to exclude those patients)

Have undergone active outpatient treatment in the past six months.

Oral Chemotherapy patients:

Oral chemotherapy patients included in sample size. Patients not receiving IV chemotherapy are not excluded from the serious side effects and care that they should receive and expect during their cancer care service. Many cancer patients are on oral chemotherapy, such as the brain, GI, pancreatic cancer patients that require the same information, education, support, follow up and side effects management as do the IV chemotherapy patients.

Manitoba

As per criteria above.

Prince Edward Island

As per criteria above.

Data and measurement considerations

While the provincial surveys used to produce the patient satisfaction results are all based on the AOPSS tool, inclusion criteria for patients may vary among provinces. As well, the results presented in this report are based on the latest surveys conducted in each province, but the years the surveys were conducted vary among provinces (from 2011 to 2013). While progress has been made, work is still needed to ensure that inclusion and exclusion criteria are consistent across all hospitals and jurisdictions to allow results to be compared within and among jurisdictions. Any deviation from these criteria are identified above and should be considered when interpreting results.

In Nova Scotia, Manitoba and Prince Edward Island, surveyed patients had received disease-oriented treatment within three months of the survey period, whereas in Alberta and Saskatchewan, patients had had treatment within six months of the survey.

The survey consistently captures data on patients receiving radiation treatment, but chemotherapy treatment data collection may vary by province (e.g., whether patients receiving oral chemotherapy alone were included rather than only those receiving intravenous chemotherapy).

It is important to be cautious when interpreting results in this section given that individuals may not have recalled all facets of care that took place when they received disease-oriented treatment three to six months earlier.